Predictors of problems reported on the EQ-5D-3L dimensions among people with impaired vision in northern Portugal

Abstract

Background The EQ-5D index often fails to detect the effect of ophthalmic diseases and sight loss. Investigating predictors of individual EQ-5D health dimensions might reveal the underlying reasons. The aim of this study was to investigate predictors of health dimension ratings obtained with the EQ-5D-3L from participants with impaired vision representing a spectrum of eye diseases. Methods Observational cross-sectional study with participants recruited at four public hospitals in Portugal. Outpatients with visual acuity of 0.30 logMAR(6/12) or worse in the better-seeing eye were invited to participate. Participants completed two instruments: the EQ-5D-3L (measures participants’ perceived health-related quality-of-life) and the Massof Activity Inventory (measures visual ability–ability to perform vision-related activities). This study used logistic regression models to identify factors associated with responses to the EQ-5D-3L. Results The study included 492 participants, mean age 63.4 years (range = 18–93), 50% females. The most common diagnosis was diabetic retinopathy (37%). The mean visual acuity in the better seeing eye was 0.65 logMAR (SD = 0.48) and the mean visual ability was 0.62 logits (SD = 2.04), the correlation between the two was r = − 0.511 (p < 0.001). Mobility and self-care were the health dimensions with the fewest problems (1% reported extreme problems), anxiety and depression the dimension with the most problems (24% reported extreme problems). ROC curve analysis showed that the EQ-5D index was a poor predictor of cases of vision impairment whilst visual ability given was a good predictor of cases of vision impairment. Visual ability was an independent predictor of the response for all dimensions, higher ability was always associated with a reduced odds of reporting problems. The odds of reporting problems were increased for females in 3 out of 5 dimensions. Comorbidities, visual acuity and age-category were predictors of the odds of reporting problems for one dimension each. Conclusions The odds of reporting problems for the five health dimensions of the EQ-5D-3L were strongly influenced by the ability to perform vision-related activities (visual ability). The EQ-5D index showed poor performance at detecting vision impairment. These findings are informative and relevant for the clinic and for research evaluating the impact of eye diseases and disease treatments in ophthalmology.

Self-reported symptoms of everyday executive dysfunction, daytime sleepiness, and fatigue and health status among adults with congenital aniridia: a descriptive study

“…Their EQ-5D-5L index scores were also similar to those of adults with other chronic eye diseases (Langelaan et al, 2007 ; Senra et al, 2022 ). Pain/discomfort was the most frequently (65%) affected health domain of the EQ-5D-5L, and pain/discomfort appeared higher in this aniridia sample than in other populations with ophthalmic diseases (Langelaan et al, 2007 ; Macedo et al, 2022 ). The EQ-5D-5L has been widely used in quality-of-life research in populations with chronic conditions and ophthalmic diseases (Langelaan et al, 2007 ; Senra et al, 2022 ; Zhou et al, 2021 ).…”

EQ‐5D‐5L health utility scores in Australian adults with inherited retinal diseases: A cross‐sectional survey

“…This suggests that EQ-5D-5L utility values may not be sensitive to the reduced quality of life associated with all types and stages of vision impairment due to IRDs. This lack of discrimination has also been noted when assessing the EQ-5D-3L among people with neovascular age-related macular degeneration (Payakachat et al, 2009), primary open-angle glaucoma (Browne et al, 2012), diabetic macular oedema (Kay & Ferreira, 2014) and other causes of low vision (Lin & Yu, 2012;Macedo et al, 2022), along with a lack of responsiveness to low vision rehabilitation (Malkin et al, 2013). To our knowledge, the EQ-5D-5L and NEI-VFQ have not been compared in people with IRDs to date.…”

The Basic VRS-Effect Study: Clinical Trial Outcomes and Cost-Effectiveness of Low Vision Rehabilitation in Portugal

“…The EQ-5D-5L index has been considered to have low responsiveness to the effects of vision rehabilitation; therefore, our results for the cost-effectiveness have limitations [38,73]. The fact that we used the EQ-5D-5L, an instrument with limited responsiveness to vision rehabilitation, is a limitation to the results of the current trial [74].…”